19 April 2019

Zimbabwe: Psychosocial Support, Safe Spaces a Stitch in Time

A small tent is pitched near a maternity ward at Chipinge Provincial Hospital in Manicaland Province. About 70 kilometres away, another tent is pitched in a soccer pitch at Chimanimani High School and women form a beeline as they wait for their turn to enter.

Though small, the tents known as safe spaces, have been performing a gigantic role, becoming a "refuge" for Cyclone Idai victims who walk in and out to receive psychosocial support services.

In the safe spaces, Musasa Project counsellors patiently listen and speak to victims and survivors of Cyclone Idai.

Funded by UNFPA and implemented by Musasa Project, the safe spaces do not only cater for victims of Cyclone Idai, civil servants (some of them victims of the devastating cyclone) and other volunteers who have been working and assisting since floods hit the area have also been coming in for psychosocial help).

UNFPA has also been working closely with the Government through the Ministry of Women's Affairs, Community, Small and Medium Enterprises Development, tackling issues like gender-based violence affecting survivors of Cyclone Idai.

They have also partnered Africa University to provide psychosocial support.

Psychosocial support is important as it helps individuals and communities to heal the psychological wounds and rebuild social structures after an emergency or a critical event.

It can help change people into active survivors rather than passive victims.

In March, Cyclone Idai altered the lives of thousands of Zimbabweans in many ways than imagined, perforating the social structures and leaving "internal wounds" that may last a lifetime in cases where no counselling is provided.

An estimated 85 000 people in Chimanimani, 50 015 in Chipinge, 8 085 in Mutare, 15 800 in Buhera, 325 in Mutasa and 245 in Makoni were affected.

The most hard-hit areas in Chimanimani were Ngangu and Kopa, while several people were displaced in Machongwe, Chikukwa, Nyahode, Peacock, Muchadziya and Vimba.

When the cyclone destroyed communities, Government workers that include those in health institutions, police, civil protection, and volunteers among others played a huge role as first responders.

They saw it all, from dead bodies to trapped victims, seriously injured people, displaced children and homes reduced to the ground.

In Chimanimani, many such workers who have been providing assistance to rebuild lives of those affected have themselves been affected and are still trying to find closure.

One case is that of a nurse at Chimanimani Hospital (name withheld), who lost a 10-roomed house, sewing machines and all her furniture.

She was on night duty at the clinic when Cyclone Idai swept away her home.

The nurse only managed to go and see the extent of the damage after three days as she had to also work and help victims who had been injured.

Neighbours rescued her three children who were alone at home.

Since she was left with nothing, she is staying in a mothers waiting shelter ward with the few belongings that have been donated to her.

Then the headmaster of Chimanimani High School where hundreds of Cyclone Idai victims are housed refuses to leave a room in his house following the disaster.

When disaster struck, he had gone to Skyline and reportedly walked from there to Chimanimani High School as most roads were blocked or had given in.

He immediately told his family to leave Chimanimani as he feared the worst.

He could not leave the school as it is one of the centres housing hundreds of Cyclone Idai victims. The school is also a feeding and aid collection point.

There are other workers who also lost everything, even family members in the floods, but still come to work round the clock to attend to those in worse off situations than theirs. These are the unsung heroes of Cyclone Idai, who after going through a horrendous experience themselves, still soldier on and give their all to ensure other affected people get necessary help.

It is such dedicated people who also need psychosocial support services to get through the trauma brought by Cyclone Idai.

A counsellor with Musasa Project Ms Faith Mtetwa said they were indiscriminately offering psychosocial support to all victims of Cyclone Idai who managed to come to the hospital.

"We are focusing on every survivor, but today we just looked at women who are being referred from the maternity ward," she said.

"When I went to Ward 15, Muzita, yesterday, I visited five households. Of the households I visited, I spoke to three ladies and two men giving them psychosocial support."

Most of the victims she spoke to were deeply hurt and grieving.

"They lost their relatives and belongings," said Ms Mtetwa.

"Some of the women who came were airlifted and do not even know how their families are faring back home.

"Some say their husbands are in Johannesburg and they do not know who will help them rebuild their homes.

"As for food, they are depending on aid."

While Ms Mtetwa has come across extremely sad stories of survivors, there are some that broke her heart.

"The worst case I attended to is that of an ECD teacher who lost everything," she said.

"The school where she worked was swept away. She also lost some kids she had taught and grown close to. She cried throughout the session."

Most teenage girls coming in for psychosocial support are young and pregnant and their husbands working outside Zimbabwe.

"Before the cyclone, some were already in a difficult position as their in-laws did not approve of the relationships," said Ms Mtetwa. Such teenage girls stayed in small homes which were destroyed.

"They have a double problem," said Ms Mtetwa.

"They cannot go to their husbands in South Africa, have no food to eat and no shelter."

Ms Mtetwa said psychosocial support is important post-disaster as it focuses on the unseen.

"When most people see someone who has been attacked, they immediately think they need food, clothes and a tent e.t.c," she said.

"But, when we saw them when they came, we realised that they needed psychosocial support because they broke down.

"Everyone needs that companionship, that listening ear, an arm to lean on, someone to show them 'we are with you' even when you are not providing material things."

In post-disaster situations, cases of gender-based violence also come in through all forms including, economically, physically and emotionally.

Women and girls are usually the worst affected and sometimes do not have anyone to talk to.

UNFPA Country Representative Dr Esther Muia said Government's response to workers affected by Cyclone Idai, especially in the health sector has been commendable.

"At Chimanimani Hospital, we noticed that more health workers were brought in to help nurses who were affected," she said.

"This is because it was recognised that those affected could not work under the circumstances.

"They lost their families, properties and colleagues at work. The health sector has proactively gone out to provide additional help, temporary as it may be. The social sector has taken time to bring in relief, but they have begun trickling in."

A taskforce was formed under the auspices of the mental health department at Mutare Provincial Hospital.

"They have been working with Africa University and by day three of the cyclone, some members had been sent on the ground to see how to help the people, including the service providers," said Dr Muia.

"The Manicaland Mental Health Taskforce is doing a two-pronged approach.

"Apart from addressing victims, including service providers who are victims, they are also looking for psychosocial support for volunteers, a group that may be overlooked.

"Volunteers are not in the formal sectors, but are involved. For example, the Red Cross, there are many that are not part of it."

Dr Muia said they would like to bring the military as a sub-set under the Manicaland Mental Health Task team that is leading the psychosocial support component of the response to Cyclone Idai.

Safe spaces have also proved efficient in post-disaster periods as they also help in address gender-based violence and exploitation.

According to Dr Muia, most people, especially in the Chimanimani area, who have lost their property and homes have nowhere to go to. She believes they will become even more vulnerable because there was already an impeding drought in the area and now their crops and homes have been destroyed by the cyclone.

"They have no shelter, no food," said Muia.

"The food distribution stage works well during the emergency's initial stages. But during the recovery period, it is assumed people have gone to normal life.

"But you cannot go back to normal life when you have lost your shelter, food and family members.

"Some have lost bread winners, some themselves are breadwinners, where are you sending them back to?

"In the initial period, they have to figure out how they restart their lives again and how they rebuild themselves. They need some safe space.

"They have been traumatised. They need access to counselling and services."

As the rebuilding of infrastructure continues in areas affected by Cyclone Idai, more work should be put in understanding the thoughts, feelings, and emotions and the external world and environment of the affected people, and the relationships they have with this.

If not provided with psychosocial support in post-disaster situations, some victims could end up committing suicide.

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